2018 in Review: Impactful Literature on Pain & Opioids

At axialHealthcare, our pain and opioid care solutions are based in and continually updated with the latest peer-reviewed evidence. In order to maintain the highest standards for our products, and the patient care they support, our experts sort through thousands of publications each year.

Adding more than 100 publications to our compendium this year, we’ve compiled a list of the most relevant and impactful pieces we read in 2018 below.

Buprenorphine medication was associated with reductions in all-cause and opioid-related mortality. The suboxone group had a 40% lower death rate after one year compared with those who did not receive any medication.

Following opioid overdose, only 30% receive medication to treat addiction.

On the Moral Value of Pain and Opioids
Recommended by Katie Miller, PharmD, Principal, Clinical Product DevelopmentThis perspective piece highlights the importance of understanding appropriateness of treatment per patient. The author cautions against labeling treatments as good or bad; treating pain is much more complex. While axialHealthcare is already making an impact, there are so many exciting opportunities to improve this space.

Communicating about Opioids in AppalachiaRecommended by Lindsey Morris, PhD, Director of Data ScienceWhen discussing the opioid epidemic in Appalachian communities, the public health impact is the most commonly reported concern of subject matter experts and community members. Participants in this focus group also cited increasing criminal activity, the collapse in the workforce, and lost opportunities for economic development as contributors to the corrosive effect of the opioid epidemic.

Researchers found that clinicians who were notified of their patients’ fatal overdoses decreased opioid prescribing by ~10%, acknowledging that communicating important patient-level data can influence a clinician’s prescribing habits. axialHealthcare has the opportunity to refine and improve this approach by:

Intervening prior to an overdose event or prior to an overdose event that results in death.

Risks of Fatal Opioid Overdose during the First Year Following Nonfatal OverdoseRecommended by Brooke Defosse, PharmD, Director, Intellectual Property EnablementThis study found that adults treated for opioid overdose frequently have repeated opioid overdoses in the following year. These patients are also at high risk of fatal opioid overdose throughout this period, underscoring the importance of efforts to engage and maintain these high risk patients in evidence-based care.

Distributed Representations of Sentences and DocumentsRecommended by Kevin Wilson, VP of EngineeringA semantic embedding is a natural language processing technique that maps words and phrases to a continuous vector space for numerical comparison. At axialHealthcare, we can represent a patient’s medical claims history as “phrases” of ICD (International Classification of Diseases) and NDC (National Drug Code) “words.”

Then, using semantic embedding we have the potential to form a foundational representation of the patients to begin to understand how they relate to one another, identify healthy/unhealthy patterns, and predict directional trends.

Developing an Opioid Use Disorder Treatment Cascade: A Review of Quality MeasuresRecommended by Chad You, MD, Senior Research Data ScientistDeveloping a cascade of care model for opioid use disorder (OUD) could quantify the current gaps in care processes for individuals with OUD and provide tools for goal setting, accountability, measurement of progress, identification of needed treatment resources, and increases in the use of guideline-consistent, evidence-based care processes.

Outpatient Opioid Prescriptions for Children and Opioid-Related Adverse EventsRecommended by Meridith Peratikos, MS, Director of Statistics & Scientific CollaborationThe authors identified opioid-related adverse events out of the 1.3 million opioid prescriptions prescribed to Tennessee children over 5 years. A strength of this study is that the events were adjudicated using medical and/or death records.

In 2016, axialHealthcare performed two studies on children in episodes of pain with client data. We calculated the median Morphine Equivalent Daily Dose (MEDD) to be 15 mg on the low end and higher depending on population and age group. We found dentists, primary care providers, and emergency medicine practitioners prescribed the majority of opioids.

Reduction in Opioid Prescribing through Evidence-based Prescribing GuidelinesRecommended by Chris Muller, PhD, Senior Research Data ScientistThis particular study combines analysis of prescription claims data with patient outreach to formalize pain management best practices and curb excess opioid prescribing to mitigate the risk of opioid diversion. Authors hope the results of this study will serve as a platform for other states and organizations to develop more streamlined postoperative opioid prescribing guidelines.

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By David Simon, Ph.D., Research Data Scientist Predicting a patient’s risk for adverse outcomes is an important part of delivering precision medicine and improving the lives of patients. In order to achieve these goals, axialHealthcare has developed a number of machine learning models that quantify patient risk. An exciting example is our machine learning model…